Dziadzko Mikhail, Belhassen Manon, Van Ganse Eric, Marant-Micallef Claire, Martinez Valeria, Aubrun Frederic
Département d'Anesthésie-Réanimation, Douleur, Hôpital de la Croix Rousse, Hospices Civils de Lyon, 69004 Lyon, France.
PELyon, 69007 Lyon, France.
J Clin Med. 2024 Dec 17;13(24):7680. doi: 10.3390/jcm13247680.
Chronic pain is a common symptom in Post-Acute COVID-19 Syndrome (PACS), affecting 11-60% of patients, but the link between COVID-19 and chronic pain remains unclear. This study assesses healthcare resource utilization (HRU) for pain management among French COVID-19 survivors, using the National French Claims Database (SNDS). We analyzed medical consultations, rehabilitation services, diagnostic procedures, and medication dispensing to identify PACS-related pain patterns and their impact on the healthcare system. The cohort included 68,822 patients hospitalized during the first COVID-19 wave (March-June 2020), with 13,939 ICU survivors. HRU was assessed for six months pre- and post-hospitalization in four areas: (1) medical consultations and rehabilitation; (2) pain-related medication dispensing; (3) neuropathic diagnostic procedures; (4) hospital admissions for chronic pain. A post-pre ratio (PP-Ratio) compared post-COVID to pre-COVID HRU. Significant changes in HRU were observed, particularly for ICU survivors. Neurology consultations (PP-Ratio 1.41) and outpatient physical therapy (PP-Ratio 1.69) increased. Dispensing of strong opioids, antiepileptics, anxiolytics, and hypnotics rose, while NSAID use decreased. Hospitalizations for chronic pain also increased (PP-Ratio 1.52). Similar trends were seen among ICU survivors, with notable increases in opioid and antiepileptic use. No distinct PACS-related pain patterns emerged. Non-specific increases in HRU for pain management were found following COVID-19 hospitalization, likely due to disease severity and ICU care rather than PACS-related chronic pain. Further research is needed to explore long-term pain outcomes in this population.
慢性疼痛是新冠后急性综合征(PACS)的常见症状,影响11%至60%的患者,但新冠病毒与慢性疼痛之间的联系仍不清楚。本研究利用法国国家索赔数据库(SNDS)评估了法国新冠幸存者疼痛管理的医疗资源利用情况。我们分析了医疗咨询、康复服务、诊断程序和药物配给,以确定与PACS相关的疼痛模式及其对医疗系统的影响。该队列包括在第一波新冠疫情(2020年3月至6月)期间住院的68822名患者,其中13939名是重症监护病房幸存者。在四个领域评估了住院前后六个月的医疗资源利用情况:(1)医疗咨询和康复;(2)与疼痛相关的药物配给;(3)神经性诊断程序;(4)慢性疼痛住院治疗。采用前后比值(PP-比值)比较新冠后与新冠前的医疗资源利用情况。观察到医疗资源利用有显著变化,尤其是重症监护病房幸存者。神经科会诊(PP-比值1.41)和门诊物理治疗(PP-比值1.69)增加。强效阿片类药物、抗癫痫药、抗焦虑药和催眠药的配给量增加,而非甾体抗炎药的使用减少。慢性疼痛住院治疗也有所增加(PP-比值1.52)。重症监护病房幸存者中也出现了类似趋势,阿片类药物和抗癫痫药的使用显著增加。没有出现与PACS相关的明显疼痛模式。新冠病毒住院治疗后,发现疼痛管理的医疗资源利用出现非特异性增加,这可能是由于疾病严重程度和重症监护,而非与PACS相关的慢性疼痛。需要进一步研究来探索该人群的长期疼痛结局。